Otherworlde MDC 103: Ethics, or the Lack Thereof

This was it. The last assignment before Amelia would be moving to the Blood Dormitories and becoming an Intermediate-level student. She had already passed all of her classes, and she knew that. She had done the work that she needed to do, and she did her best. But she still had one more assignment to go before the term was over, and even though she technically did not really need to do it, she would do so anyway. For completion’s sake.

It was just a simple essay anyway, nothing too difficult. The hardest and most time-consuming thing that Amelia had to do in her classes by far was to take care of that mannequin with the simulated concussion. Compared to that, a report was no problem at all. All that Amelia had to do for this assignment was to write about the main ethics of medicine… and then how one could go about breaking or ignoring those rules.

She could do that.

Both the writing and the breaking of the rules, that is.

But for now, all she had to do was write.

MDC 103
Assignment #3
By Amelia Hawthorn

There are four basic tenets of ethics in the medical field. They are simple, pervasive throughout the field of medicine, and can range from extremely useful to extremely limiting. In this essay, I will list and describe these four tenets, and then discuss how they could be broken and why one may choose to do so.

In her description of the assignment, Professor Katja had never actually asked her students to explain why they might want to break the core rules of medical ethics. Amelia wondered if her professor just thought that chaos was the basic state of things, and that breaking rules was just second nature to Katja. Amelia had no problem breaking rules herself, as long as it was for a good reason – though that reason could range anywhere from ‘I can help more people if I break this rule’ to ‘the rule was getting in my way and it was very tedious trying to follow it’. And, of course, she did not want to go around breaking rules if she thought she would get caught. In Amelia’s mind, much like Cressida’s, she could never afford to fail.

1. Autonomy. This rule requires that the patient or test subject must consent fully to the procedure that will be conducted on them. They must be completely informed as to the nature of the procedure, as well as the risks, benefits, and probability of success. They cannot be forced or coerced to participate.  The patient must have complete autonomy of intention, action, and thought when deciding whether or not to undergo the procedure or procedures in question.

This rule is exceptionally easy to break. All one would have to do in order to violate the principle of autonomy is to, for example, not inform the subject of the full extent of the procedure, or force them or coerce them against their will to be subjected to the procedure. It would be useful to break this ethical rule if the individual in question needs to have a procedure done to save their life or improve their condition in some way, but they are an idiot and will not listen to you, and repeatedly refuse the procedure because they are too afraid or ignorant to understand it. Additionally, there are many individuals with unusual or otherwise interesting anatomy and physiology here at Otherworlde Academy, and many of them belong to species that have not been studied extensively. To not attempt to study them simply because they refuse to allow you to do so would be an extreme waste of materials. As such, this rule could also be broken when the knowledge to be gained from the procedure outweighs the autonomy of the individual in terms of total benefit.

There really were a lot of interesting students at Otherworlde Academy. Amelia had already chosen to vivisect one of the strange fungus creatures in the Beast Studies building, but she supposed she could always study her fellow students in her own time. Amelia remembered what Cressida had told her – that where she had come from, before arriving at Otherworlde Academy, her home city had been populated almost entirely with humans. Amelia felt slightly sorry for all the people in Cressida’s old city who would never get the chance to interact with another sentient magical creature and learn about them.

2. Justice. This rule states that new medicines, medical devices, experimental treatments, etc. should be equally distributed among all groups in a society, so that all people will have fair access to them. There are multiple factors that must be taken into account with this rule, such as existing legislation, the rights of humans and other species of human-like intelligence and ability, distribution of resources, and competing needs between individuals or populations.

One way to break this rule would be to withhold a treatment or device from a specific group of people, whether out of prejudice against them, for the purpose of economic gain, or for an entirely different motivation. I have no interest in breaking this rule in this manner. However, it is possible that this rule could also be broken to withhold a treatment from a specific individual who is evil, hindering progress, or would otherwise benefit society more if they did not have access to this treatment and died.

3. Beneficence. This rule requires that the procedure in question is conducted to have a positive outcome for the patient involved. It must be performed with the intention to do things that are good. This rule could be broken if, as in the previous case involving a corrupt individual, doing something that is beneficial to one specific patient may be detrimental to the world as a whole. An example of this rule being broken would be to knowingly provide a placebo for a patient despite their need of the actual medication, as that medication would be better used elsewhere.

4. Non-maleficence. This rule states that a procedure must not be designed to do harm to the patient or others in society. The greater good must be pursued in any case, and if harm cannot be avoided, it must be minimized whenever and wherever possible.

Obviously, the easiest way to break this rule at Otherworlde Academy would be to use one’s Medical Studies expertise to kill someone or otherwise injure them. It is highly probable that I will break this rule in the future, as I plan to eventually enter the Otherworlde Academy Tournament.

By the time Amelia was done with her essay, she was no longer really worried about her own morality, regardless of her sadistic streak and her willingness to break the rules of medical ethics. She had just gotten some unexpected results on her expedition to the forest, that was all, and that had caused her to question her own moral standards. But by now, she had finally come to a conclusion about who she was. About what kind of person she really was, and wanted to be.

Amelia Hawthorn was a good person, she decided. Amelia Hawthorn simply went about it in unorthodox ways.